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NPI Code Detail

MEDICARE: DR. CAROLE ELLEN LANDMAN D.D.S.

MEDICARE:  DR. CAROLE ELLEN LANDMAN  D.D.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice DentistryIL

General Provider Information

NPI Number : 1871794735
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CAROLE ELLEN LANDMAN D.D.S.
Provider Business Mailing Address
First Line : 3700 N LAKE SHORE DR APT 301
Second Line :
City : CHICAGO
State : IL
Zip : 60613-4244
Country : US
Telephone Number : 773-935-1229
Fax Number :
Provider Business Practice Location Address
First Line : 625 N MICHIGAN AVE STE 1020
Second Line :
City : CHICAGO
State : IL
Zip : 60611-3114
Country : US
Telephone Number : 312-266-6480
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/29/2007
Last Update Date : 07/08/2007

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Directions to “ DR. CAROLE ELLEN LANDMAN D.D.S.” Practice Location

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